The Effect of Non-Surgical Therapy on the Markers of Oxidative Stress in Patients with Chronic Periodontitis

Abstract

Background and Purpose: Several investigators have analyzed the role of oxidative stress in the pathogenesis of periodontitis. Chronic inflammatory disease may be associated with an imbalance of increased markers of oxidative stress and reduced antioxidant defenses, which has been shown to return to normal levels with successful non-surgical therapy. This systematic review focused on all available evidence of the effect of non-surgical periodontal therapy on markers of localized oxidative stress in patients with periodontitis. Methods: An electronic search was conducted to identify all clinical trials that evaluated oxidative stress biomarkers in patients pre- and post-treatment with periodontitis and clinical parameters of the disease. Three reviewers conducted the search and verification of article selection. Eligibility criteria were applied to determine the final selection of publications for full text review. Bibliographies of relevant papers were searched for additional studies and a search of periodontal journals published in the last 3 years was performed to verify inclusion of all available clinical trials. Results: The initial search of three databases yielded 2,523 articles. The final selection consisted of 13 articles after removing those that did not include non-surgical therapy of periodontitis or markers of oxidative stress in systemically healthy patients. Change of oxidative stress markers (OSM) ranged from 0 to 81 percent. A statistically significant reduction of OSM was reported in 8 studies. 5 studies were used to calculate the unweighted percent change, which was 48.74%, and the weighted percent change, which was 57.83%. Conclusions: There is high variability in the OSM concentrations in periodontitis patients. OSM decreased following non-surgical therapy. More longitudinal, randomized clinical controlled trials of are required to understand the modulation of OSM following periodontal treatment.